Contributed by – Healthians team

While experts around the world are assuring that most people only suffer from a mild form of COVID-19, China and South Korea warned the world that some of the “cured” patients were testing positive again a few days or weeks later. India has also seen two such cases in Noida where two people tested positive again after discharge. This could be a serious concern as patients who have “recovered” will get back to normal life and potentially infect many.

Every disease has a treatment protocol which is almost always accepted and followed worldwide. However, since COVID-19 is a new disease, such a protocol is yet to be formulated. China, where the Coronavirus was first discovered, has largely contained the virus in their country. It recently recommended to the world the procedure they followed for discharging the COVID-19 patients.

Their recommendation is that patients should be discharged when – they don’t have a fever for three days in a row; their respiratory symptoms have improved; inflammation in respiratory tracts has reduced; they test negative twice for the COVID-19 test in consecutive samples taken at least 24 hours apart. Additionally, a patient once discharged should stay in isolation for 14 more days and wearing a face mask is mandatory for them. They should also visit the hospital for a checkup after two weeks and then again after four weeks.

Most countries are following this protocol with little alterations as per their own clinical experiences. In India, a COVID-19 patient is only discharged once their key symptoms (fever, respiratory difficulties and coughing) disappear, they consecutively test negative twice within 24 hours and chest radiograph shows clearance for the virus. 14-day isolation for cured patients is recommended in India as well.

Coronavirus recovered patients - Healthians

But, if COVID-19 patients are only being discharged after their symptoms have disappeared and they have tested negative twice, what is making them test positive again after some days? Well, there are many possible explanations for that.

As far as the possibility of re-infection is concerned, researchers think it is unlikely to happen. People who contract the infection develop antibodies against the virus which can ideally fight off the virus upon the second encounter. However, this cannot be said with certainty because not all recovered patients develop antibodies.

Instead of re-infection, researchers are leaning towards the possibility of relapse or reactivation of the virus. It could mean that the virus or parts of the virus go into a dormant state for some time or in the case of patients with compromised immunity the virus might reactivate in their system.

Researchers are also suggesting that the COVID-19 test might be detecting the remains of the virus in recovered patients. There’s a possibility that the immune system has killed the virus and what is getting detected are the lingering pieces of its genetic material.

It is yet to be known how the body sheds the virus after recovering from it. Since the symptoms are no more there, there’s no coughing or sneezing. Hence, respiratory droplets are not emitted as easily.

As of now, health authorities have not found any case where the reactivated patient has spread the virus to third parties. However, it is essential to practice all the necessary precautions including social distancing as we never know who might be a carrier for the virus


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